Pearson Vue National Health Insurance Practice Test Complete Solutions
1. How many days after receiving notice of an Accident & Health claim must an insurer provide claim
forms to an insured?
A. Five
B. Fifteen
C. Twenty
D. Thirty
Correct answer: D. Thirty
2. What factor cannot be used by an employer to offer additional benefits to classes of employees under
a group health plan?
A. Length of employment
B. Gender
C. Salary grade
D. Job category
Correct answer: B. Gender
3. What is true about a Waiver of Premium provision in a Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's benefit payments.
B. It allows the insurer to increase the amount of premium during the insured's time of disability.
C. It allows the insured to extend the length of the Grace Period while disabled.
D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums.
,Correct answer: D. It allows the insured to maintain a policy in force while disabled and unable to pay
premiums.
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
A.increase the premium rate for one insured without increasing the rate for others in the same class
A. increase the premium rate for one insured without increasing the rate for others in the same class
B. increase the premium rate for an entire class of insureds
C. increase the benefits for an individual insured
D. decrease benefits for one insured without decreasing benefits for others in the same class ✔️b
An individual who has had a heart murmur since birth is likely to be issued an individual disability policy
that includes:
A. Guaranteed Insurability rider
B. an Exclusionary/ Impairment rider
C. Waiver of Premium rider
D. Double Indemnity rider ✔️b
Which of the following statements is CORRECT about coinsurance?
A.It applies to deductibles as well as to claim payments.
A. It applies to deductibles as well as to claim payments.
, B.It helps control overutilization of benefits.
C. It is effective for the first claim payment and waived for future claims.
D. Insurance companies may adjust the coinsurance ratio after issuing a policy. ✔️b
The insurance policy clause that identifies the contracting parties and defines the scope and limits of
coverage is called the:
A. Insuring clause
B. Benefit clause
C. Consideration clause
D. Renewal clause ✔️a
In an Accidental Death and Dismemberment (AD&D) policy, the term "capital sum" refers to:
A.the benefit paid for death caused by a dread disease
A. the benefit paid for death caused by a dread disease
B. the monthly disability income paid if an insured loses a limb or the sight in one or both eyes
C. a lump sum payment made when disease causes the amputation of an arm or a leg
D. a lump sum payment made for an accidental dismemberment ✔️d
1. How many days after receiving notice of an Accident & Health claim must an insurer provide claim
forms to an insured?
A. Five
B. Fifteen
C. Twenty
D. Thirty
Correct answer: D. Thirty
2. What factor cannot be used by an employer to offer additional benefits to classes of employees under
a group health plan?
A. Length of employment
B. Gender
C. Salary grade
D. Job category
Correct answer: B. Gender
3. What is true about a Waiver of Premium provision in a Disability Income policy?
A. It allows the insurer to deduct premiums due from the disabled insured's benefit payments.
B. It allows the insurer to increase the amount of premium during the insured's time of disability.
C. It allows the insured to extend the length of the Grace Period while disabled.
D. It allows the insured to maintain a policy in force while disabled and unable to pay premiums.
,Correct answer: D. It allows the insured to maintain a policy in force while disabled and unable to pay
premiums.
Under a Guaranteed Renewable Accident & Health policy, an insurer retains the right to:
A.increase the premium rate for one insured without increasing the rate for others in the same class
A. increase the premium rate for one insured without increasing the rate for others in the same class
B. increase the premium rate for an entire class of insureds
C. increase the benefits for an individual insured
D. decrease benefits for one insured without decreasing benefits for others in the same class ✔️b
An individual who has had a heart murmur since birth is likely to be issued an individual disability policy
that includes:
A. Guaranteed Insurability rider
B. an Exclusionary/ Impairment rider
C. Waiver of Premium rider
D. Double Indemnity rider ✔️b
Which of the following statements is CORRECT about coinsurance?
A.It applies to deductibles as well as to claim payments.
A. It applies to deductibles as well as to claim payments.
, B.It helps control overutilization of benefits.
C. It is effective for the first claim payment and waived for future claims.
D. Insurance companies may adjust the coinsurance ratio after issuing a policy. ✔️b
The insurance policy clause that identifies the contracting parties and defines the scope and limits of
coverage is called the:
A. Insuring clause
B. Benefit clause
C. Consideration clause
D. Renewal clause ✔️a
In an Accidental Death and Dismemberment (AD&D) policy, the term "capital sum" refers to:
A.the benefit paid for death caused by a dread disease
A. the benefit paid for death caused by a dread disease
B. the monthly disability income paid if an insured loses a limb or the sight in one or both eyes
C. a lump sum payment made when disease causes the amputation of an arm or a leg
D. a lump sum payment made for an accidental dismemberment ✔️d
